Effects of Continuous Positive Airway Pressure on Quality of Life in Patients With Moderate to Severe Obstructive Sleep Apnea: Data From a Randomized Controlled Trial
Open accessAbstract
STUDY OBJECTIVES: Previous studies have shown that CPAP has a substantial impact on daytime symptoms and quality of life (QOL). It remains unclear which outcome measures best identify real CPAP effects and carry independent information. METHODS: One hundred-two men with moderate-severe obstructive sleep apnea were randomized to either "real" or "sham" CPAP for one month. Outcome measures were subjective sleepiness (Epworth Sleepiness Scale [ESS]) and QOL measures includiig SF-36/SF-12 and Calgary Sleep Apnea Quality of Life Index (SAQLI). The bed partner's QOL and rating of patient's response to CPAP were assessed with the Dublin questionnaire. All data were standardized using effect sizes and expressed as real minus sham to remove the nonspecific effects of placebo. RESULTS: Real CPAP was superior to sham CPAP in almost all outcome measures. ESS, patient's component from Dublin, and social interactions from SAQLI showed the largest differences in effect sizes between real and sham (1.33, 0.98, and 0.92 respectively). ESS carried the highest predictive power of real CPAP response (P < 0.0001, r2 = 0.21). Question number 5 from Dublin (partner assessed patient's sleep quality) and question 6 from ESS (dozing while talking) were the best single item predictors of real CPAP response. CONCLUSIONS: Real CPAP reduces subjective sleepiness and improves QOL of both patients and bed partners. ESS is the best score; question number 5 from Dublin and question number 6 from ESS are the best single item predictors of real CPAP response. This information should allow the selection of appropriate questions in clinical practice and research protocols.
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Cites
(1992) · PubMed · Cited by 33,716 · see citing works
WARE, J. E., KOSINSKI, M., & KELLER, S. D. (1996) · Medical Care · doi:10.1097/00005650-199603000-00003 · Cited by 17,392 · see citing works
A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale
Johns, M. W. (1991) · Sleep · doi:10.1093/sleep/14.6.540 · Cited by 17,364 · see citing works
The Occurrence of Sleep-Disordered Breathing among Middle-Aged Adults
Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S., & Badr, S. (1993) · New England Journal of Medicine · doi:10.1056/nejm199304293281704 · Cited by 10,183 · see citing works
Epidemiology of Obstructive Sleep Apnea: A Population Health Perspective
Young, T., Peppard, P. E., & Gottlieb, D. J. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.2109080 · Cited by 4,244 · see citing works
The Medical Outcomes Study. An application of methods for monitoring the results of medical care
Tarlov, A. R. (1989) · JAMA · doi:10.1001/jama.262.7.925 · Cited by 1,214 · see citing works
Pepperell, J., Ramdassingh-Dow, S., Crosthwaite, N., Mullins, R., Jenkinson, C., Stradling, J. R., & Davies, R. J. O. (2002) · The Lancet · doi:10.1016/s0140-6736(02)07445-7 · Cited by 1,055 · see citing works
Self-citationContinuous positive airways pressure for obstructive sleep apnoea in adults
Giles, T., Lasserson, T., Smith, B., White, J., Wright, J., & Cates, C. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001106.pub2 · Cited by 1,001 · see citing works
Jenkinson, C., Layte, R., Jenkinson, D., Lawrence, K., Petersen, S., Paice, C., & Stradling, J. (1997) · Journal of Public Health · doi:10.1093/oxfordjournals.pubmed.a024606 · Cited by 971 · see citing works
Self-citationJenkinson, C., Davies, R. J., Mullins, R., & Stradling, J. R. (1999) · The Lancet · doi:10.1016/s0140-6736(98)10532-9 · Cited by 826 · see citing works
Self-citationENGLEMAN, H. M., KINGSHOTT, R. N., WRAITH, P. K., MACKAY, T. W., DEARY, I. J., & DOUGLAS, N. J. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.159.2.9803121 · Cited by 558 · see citing works
Development and Testing of the UK SF-12
Jenkinson, C., & Layte, R. (1997) · Journal of Health Services Research & Policy · doi:10.1177/135581969700200105 · Cited by 493 · see citing works
Continuous positive airways pressure for obstructive sleep apnoea in adults
Giles, T., Lasserson, T., Smith, B. J., White, J., Wright, J., & Cates, C. J. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001106.pub3 · Cited by 383 · see citing works
Effect of CPAP therapy on daytime function in patients with mild sleep apnoea/hypopnoea syndrome
Engleman, H. M., Martin, S. E., Deary, I. J., & Douglas, N. J. (1997) · Thorax · doi:10.1136/thx.52.2.114 · Cited by 340 · see citing works
Development of a Disease-specific Health-related Quality of Life Questionnaire for Sleep Apnea
WARD FLEMONS, W., & REIMER, M. A. (1998) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.158.2.9712036 · Cited by 333 · see citing works
Health-related quality of life in obstructive sleep apnoea
Lacasse, Y., Godbout, C., & Sériès, F. (2002) · European Respiratory Journal · doi:10.1183/09031936.02.00216902 · Cited by 320 · see citing works
Engleman, H. M., Martin, S. E., Kingshott, R. N., Mackay, T. W., Deary, I. J., & Douglas, N. J. (1998) · Thorax · doi:10.1136/thx.53.5.341 · Cited by 308 · see citing works
A behavioural test to assess daytime sleepiness in obstructive sleep apnoea
BENNETT, L. S., Stradling, J. R., & DAVIES, R. (1997) · Journal of Sleep Research · doi:10.1046/j.1365-2869.1997.00039.x · Cited by 221 · see citing works
Self-citationJenkinson, C., Stradling, J. R., & Petersen, S. (1997) · Journal of Sleep Research · doi:10.1046/j.1365-2869.1997.00043.x · Cited by 197 · see citing works
Self-citationPitson, D., & Stradling, J. R. (1998) · Journal of Sleep Research · doi:10.1046/j.1365-2869.1998.00092.x · Cited by 185 · see citing works
Self-citationMeasurement Properties of the Calgary Sleep Apnea Quality of Life Index
Flemons, W. W., & Reimer, M. A. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.165.2.2010008 · Cited by 155 · see citing works
Differentiating Obstructive and Central Sleep Respiratory Events through Pulse Transit Time
ARGOD, J., Pépin, J., & Levy, P. A. (1998) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.158.6.9804157 · Cited by 149 · see citing works
Automatic nasal continuous positive airway pressure titration in the laboratory: patient outcomes
Stradling, J. R., BARBOUR, C., Pitson, D., & Davies, R. J. O. (1997) · Thorax · doi:10.1136/thx.52.1.72 · Cited by 103 · see citing works
Self-citationDoherty, L. S., Kiely, J., Lawless, G., & McNicholas, W. T. (2003) · CHEST Journal · doi:10.1378/chest.124.6.2209 · Cited by 85 · see citing works
SF-12 : an even shorter health survey
Ware, J. (1996) · Medical Entomology and Zoology · Cited by 65 · see citing works
Kiely, J., & McNicholas, W. T. (1997) · CHEST Journal · doi:10.1378/chest.111.5.1261 · Cited by 53 · see citing works
Jenkinson, C. (2001) · QJM · doi:10.1093/qjmed/94.2.95 · Cited by 30 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [7]7. Wright L, Harwood D, Coulter A. Health and lifestyles in the Ox- ford Region. Oxford: Health Services Research Unit, University of Oxford, 1992.
Cited by
Sorted by citations
Patil, S. P., Ayappa, I. A., Caples, S. M., Kimoff, R. J., Patel, S. R., & Harrod, C. G. (2019) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7638 · Cited by 721 · see citing works
Obstructive Sleep Apnea in Adults
Veasey, S. C., & Rosen, I. M. (2019) · New England Journal of Medicine · doi:10.1056/nejmcp1816152 · Cited by 615 · see citing works
Jonas, D. E., Amick, H. R., Feltner, C., Weber, R. P., Arvanitis, M., Stine, A., Lux, L., & Harris, R. P. (2017) · JAMA · doi:10.1001/jama.2016.19635 · Cited by 267 · see citing works
Craig, S. E., Kohler, M., Nicoll, D., Bratton, D. J., Nunn, A., Davies, R., & Stradling, J. (2012) · Thorax · doi:10.1136/thoraxjnl-2012-202178 · Cited by 228 · see citing works
Self-citationObstructive Sleep Apnea and Cardiovascular Disease
Pack, A. I., & Gislason, T. (2009) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2009.01.002 · Cited by 228 · see citing works
Chai-Coetzer, C. L., Antic, N. A., Rowland, L. S., Reed, R. L., Esterman, A., Catcheside, P. G., Eckermann, S., Vowles, N., Williams, H., Dunn, S., et al. (2013) · JAMA · doi:10.1001/jama.2013.1823 · Cited by 211 · see citing works
Povitz, M., Bolo, C. E., Heitman, S. J., Tsai, W. H., Wang, J., & James, M. T. (2014) · PLoS Medicine · doi:10.1371/journal.pmed.1001762 · Cited by 147 · see citing works
Pack, A. I., Magalang, U. J., Singh, B., Kuna, S. T., Keenan, B. T., & Maislin, G. (2021) · Sleep · doi:10.1093/sleep/zsaa229 · Cited by 114 · see citing works
Obstructive sleep apnea and quality of life: comparison of the SAQLI, FOSQ, and SF-36 questionnaires
University of Arizona, T., Silva, G., Goodwin, J., Vana, K., & Quan, S. (2016) · Southwest Journal of Pulmonary and Critical Care · doi:10.13175/swjpcc082-16 · Cited by 95 · see citing works
Wimms, A. J., Kelly, J. L., Turnbull, C. D., McMillan, A., Craig, S. E., O'Reilly, J. F., Nickol, A. H., Hedley, E. L., Decker, M. D., Willes, L. A., et al. (2020) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(19)30402-3 · Cited by 95 · see citing works
Self-citationFlexible Positive Airway Pressure Improves Treatment Adherence Compared with Auto-adjusting PAP
Chihara, Y., Tsuboi, T., Hitomi, T., Azuma, M., Murase, K., Toyama, Y., Harada, Y., Aihara, K., Tanizawa, K., Handa, T., et al. (2013) · Sleep · doi:10.5665/sleep.2378 · Cited by 42 · see citing works
- Authors
- Siccoli, M. M., Pepperell, J. C. T., Kohler, M., Craig, S. E., Davies, R. J. O., & Stradling, J. R.
- Affiliations
- Churchill Hospital (GB)
- Musgrove Park Hospital (GB)
- Corresponding author
- Siccoli, Massimiliano M.
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-11
- Volume
- 31
- Issue
- 11
- Pages
- 1551-1558
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC2579969
- OpenAlex
- W229601144
- Cited by
- 161
- References
- 27
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 5 · 2023: 9 · 2022: 10 · 2021: 7 · 2020: 16 · 2019: 11 · 2018: 5 · 2017: 11 · 2016: 12 · 2015: 7 · 2014: 11 · 2013: 22 · 2012: 7
- FWCI
- 4.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- continuous positive airway pressure, obstructive sleep apnea, quality of life, subjective sleepiness, Epworth Sleepiness Scale, sham CPAP, daytime sleepiness
- MeSH terms
- Adult, Aged, Female, Health Status, Humans, Disorders of Excessive Somnolence, Male, Middle Aged, Quality of Life, Surveys and Questionnaires, Severity of Illness Index, Polysomnography, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure
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